Nephrology Dialysis Transplantation, Vol 13, Issue 9 2351-2354, Copyright © 1998 by Oxford University Press
O Liangos, R Kreutz, J Beige, G Offermann, A Distler and A Sharma
Background: Hyperhomocysteinaemia, a risk factor for
atherosclerosis, is common in haemodialysis and renal-transplant patients.
As atherosclerotic lesions in hyperhomocysteinaemia resemble those of
chronic allograft injury, we examined the hypothesis that the
C677T variant of the methylenetetrahydrofolate
reductase (MTHER) gene which is linked to elevated
plasma homocysteine levels in patients with renal failure, determines renal
allograft survival. Methods: DNA was prospectively
collected from 336 patients undergoing renal transplantation in our clinic
between 1988 and 1994 and their corresponding donors. Patient and allograft
survival was analysed by blinded review of al case records over a follow-up
period of 36 months. Additionally, we recruited 83 patients surviving with
a functional kidney allograft for at least 10 years (mean: 156, range
120-240 months). MTHFR-C77T genotype was determined by
a PCR-RFLP technique. The influence of genotype on transplant survival was
analysed by Kaplan-Meyer life-table analysis and two-tailed global log-rank
testing. Results: Frequency of the
MTHFR-C677T allele in the cohort group was identical
in recipients (0.35) and donors (0.34) and comparable to that in the
long-term allograft survivors (0.37). Furthermore, life-table analysis
revealed a similar allograft survival over 36 months between the genotype
groups (CC 74%, CT 69%, TT 75%). Other risk factors including donor and
recipient age, hypertension, body-mass index, and number of rejection
therapies were evenly distributed between the different genotype groups.
Conclusions: These findings do not support the
hypothesis that the C677T variant of the
MTHFR gene is an important determinant of
renal-transplant survival. Key words: gene mutation;
homocysteine; MTHFR gene; kidney transplantation;
renal failure; cardiovascular disease
BRIEF REPORTS
Methylenetetrahydrofolate-reductase gene C677T variant and kidney-transplant survival
Department of Internal Medicine, Division of Endocrinology and Nephrology and Department of Clinical Pharmacology, Universitatsklinikum Benjamin Franklin, Freie Universitat Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany; Corresponding author
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